Welcome to our RLE self test

To Start

Please tell us how old you are

Under 18
19-39
40-59
60+
Take Our Self Test Online
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Question 2:

Have you ever been told you have astigmatism?

Yes
No
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Question 3:

Do you have to wear glasses/contacts for?

Driving
Computer
Reading
All of the above
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Question 4:

Have you had any of the following procedures on your eyes (LASIK, PRK, RK, CATARACT SURGERY)?

Yes
No
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Question 5:

Do you suffer from multiple sclerosis, lupus, keratoconus or diabetic retinopathy?

Yes
No
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Question 6:

Which location would work best for you?

Towson
Columbia
Email

Question 7:

What email should we send the results to?

First Name

Question 8:

What is your first name?

Next
Last Name

Question 9:

What is your last name?

Next
Girl on Phone

Question 10 (the final one!):

What phone number can we call/text you at?


Question 1 of 10

Unfortunately you are not a candidate for RLE due to your age (18 or under). If you entered this age by mistake, refresh the page and select your age again.

Unfortunately you are not a candidate for RLE due to having one of the pre-existing medical conditions listed. If you entered that you have one of those pre-existing conditions by mistake, refresh the page and select your choice again.